LEVEL I CORE PRIVILEGES. EVALUATION AND CLINICAL CARE Admit, Consult, H&P, Orders

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1 GENERAL SURGERY PROCEDURE BUNDLES / (COLORECTAL, MINIMALLY INVASIVE SURGERY, BARIATRIC SURGERY, SURGICAL ONCOLOGY, TRANSPLANT, TRAUMA/ACUTE CARE/CRITICAL CARE SURGERY, THORACIC SURGERY, VASCULAR) LEVEL I CORE PRIVILEGES EVALUATION AND CLINICAL CARE Admit, Consult, H&P, Orders BREAST Incision & Drainage Breast Abscess Biopsy/Excision Breast Mass Mastectomy Fine Needle Aspir w/o Image I&D Abscess Cyst Simp Single Aspirate Abscess Hematoma Cyst Injection Procedure Only for Mammary Ductogram or Galactogram Excision Benign Lesions Removal Tun CV Cath w/pump remove mediport Biopsy Lymph Node Superficial Biopsy Deep Axillary Node(s) Identification of Sentinel Node DIGESTIVE SYSTEM Esophagus Esophageal incision, FB removal, esophageal resection, endoscopy Repair,Nissen(open)Manipulation 43300,43324,43450 Stomach Incision,Excision, Laparoscopy Diagnostic Other Gastrojejunostomy Repair Perforated Gastric / Duodenal Ulcer Splenectomy, Open Splenorrhaphy Repair Paraesophageal / Diaphragmatic hernia Esophageal Myotomy, Abdominal Approach Small Intestine/Colon/Rectum/Anus Exploratory Laparotomy Enterolysis (Lysis of Adhesions) Reduction Intussusecption Excision Meckel s Diverticulum Small Bowel Resection, 44120, Colectomy, Anastomosis Partial Colectomy, Colostomy (Hartmann) Creation Enterostomy (Jejunostomy or Ileostomy) Creation Colostomy Feeding Jejunostomy Repair Enterotomy Appendectomy Appendectomy, Drainage Abscess Debride or Excise Perineal Infection Excision Pilonidal Cyst / Sinus Drainage Intra-Abdominal Abscess (Not Appendiceal) of 11

2 LEVEL I CORE PRIVILEGES Laparoscopy Exploratory Laparoscopy with/without Biopsies Appendectomy, Laparoscopic Cholecystectomy, Laparoscopic Liver/Biliary/Pancreas Biopsy of Liver Drainage Hepatic Abscess / Simple Cyst Drainage Hepatic Amoebic or Echinococcal Cyst / Abscess Repair Hepatic Laceration Cholecystectomy, Open Common Bile Duct Exploration Cholecystoenteric Anastomosis Choledochoenteric Anastomosis Excision of Choledochal Cyst Partial Pancreatectomy Pancreaticojejunostomy (Peustow) Drainage / Debride Infection Internal Drainage Pseudocyst External Drainage Pseudocyst HEAD AND NECK Thyroid Lobectomy Total Thyroidectomy Parathyroidectomy Tracheostomy GENITOURINARY Adrenalectomy, Open Cystotomy Cystostomy Cystectomy Partial Nephrectomy Closure Enterovesical Fistula Oophorectomy Salpingectomy Excision Ovarian Cyst Excision Urachal Cyst or Sinus HERNIA Inguinal Adult Umbilical Adult Femoral Ventral Incisional Initial Ventral Incisional Recurrent Remove Infected Abdominal Mesh SKIN / SUBCUTANEOUS Incision and Drainage, Debridement, Excision of skin and subcutaneous lesions, Removal of Nails,Pilonidal Cysts Wound closure, laceration repair Skin Grafting Burns Treatment Destruction of skin lesions of 11

3 LEVEL I CORE PRIVILEGES THORACIC Excision Esophageal Lesion, Primary Repair Cricopharyngeal Myotomy Heller Myotomy, Open (Thoracic Approach) Cervical Esophagostomy Esophageal Perforation Repair / Drainage Thoracentesis Tube Thoracostomy Pulmonary Descortication, Open VASCULAR Repair Trauma / Injury Major Vessel Ligation Major Vessel Placement Hickman / Broviac Catheter Placement Implantable Port Remove Catheter / Implantable Port Thromboembolectomy Lower Extremity Vein Stripping Amputation Digit Simple / Ray Amputation Transmetatarsal Amputation Below Knee Amputation Above Knee Amputation Guillotine Upper Extremity Fasciotomy Lower Extremity Fasciotomy ENDOSCOPY Upper GI Endoscopy Sigmoidoscopy Colonoscopy Bronchoscopy (Flexible/Rigid) ADMINISTRATION OF SEDATION AND ANALGESIA 3 of 11

4 COLORECTAL Complex Anorectal Procedures Stapled Hemorrhoidpexy (PPH) Repair Complex Anorectal Fistulae 46707, 46710, 46712, 46288, 46270, 46280, 46275, 45562, Closure Rectovaginal Fistula Perineal Approach Closure Rectovaginal Fistula Abdominal Approach Operation for Incontinence/Constipation Open Transabdominal Operation for Rectal Prolapse 45540, 45541, Laparoscopic Transabdominal Operation for Rectal Prolapse 45400, Perineal Operation for Rectal Prolapse 45540, 45541, Transanal Resection for Tumor/Polyp 45171, Pelvic Exenteration Operations for Anal Cancer 45110, 45112, Presacral Masses/Cysts/Tumors Hidradenitis Excision 11470, Abdominal and Perineal Prolapse Repairs 45540, 45541, Sphincteroplasty, Artificial Sphincter Implantation, Sacral Nerve Stimulation 46750, 46751, 46760, 46761, Post Episiotomy Perineal Body Reconstruction Total Abdominal Colectomy for Constipation 44150, 44151, EUA/Acetic Acid Inspection, Local Fulguration Local Resection, APR 45110, 45112, Complex Colon Procedures Colectomy with: Low Anterior Resection (lateral stalk ligation) 44145, Coloanal Anastomosis 44145, 44146, thru Colonic Pouch/Coloplasty Abdominoperineal Resection 45110, 45112, Pelvic Exenteratoin/Posterior Exenteration Endorectal Pullthrough IPAA 44120, Proctectomy Laparoscopic Colon Procedures All Laparoscopic colon procedures (including lap assisted, hand assisted, regardless of diagnosis) Ileocolectomy, TAC/Ileostomy/IRA, Sigmoid/Sleeve Resection, IPAA, etc , 44204, 44205, 44206, 44207, 44208, 44210, 44211, 44212, 44213, 44227, 45395, 45397, 45400, of 11

5 ADVANCED LAPAROSCOPY/MINIMALLY INVASIVE SURGERY Gastrointestinal (laparoscopically or endoscopically) Gastrotomy Gastrojejunostomy Suture Repair Bleeding Ulcer Pyloromyotomy Gastric Wedge Resection Hemi-Gastrectomy without Vagotomy Hemi-Gastrectomy with Vagotomy 43632/43635 Total Gastrectomy Vagotomy and Pyloroplasty Highly Selective Vagotomy Nissen Fundoplication, Laparoscopic Heller Myotomy, Laparoscopic Repair Perforated Gastric / Duodenal Ulcer Repair Paraesophageal / Diaphragmatic hernia Esophageal Myotomy, Abdominal Approach Reduction Intussusecption Excision Meckel s Diverticulum Small Bowel Resection, Anastomosis Small Bowel Resection, Enterostomy Partial Colectomy, Anastomosis Partial Colectomy, Colostomy (Hartmann) Total Colectomy, Anastomosis Total Abdominal Colectomy, Ileostomy Colectomy, Laparoscopic Total Proctocolectomy with Ileostomy Creation Enterostomy (Jejunostomy or Ileostomy) Creation Colostomy Revision Enterostomy Revision Colostomy Takedown Colostomy Takedown Ileostomy Feeding Jejunostomy Repair Enterotomy Abdominoperineal Resection Ileocecectomy Low Anterior Resection Liver/Pancreas/Biliary/Spleen (laparoscopically or endoscopically) Splenectomy, Splenorrhaphy Biopsy of Liver Hepatic Resection Drainage Hepatic Abscess / Simple Cyst Drainage Hepatic Amoebic or Echinococcal Cyst / Abscess Repair Hepatic Laceration Common Bile Duct Exploration Cholecystoenteric Anastomosis Choledochoenteric Anastomosis Excision of Choledochal Cyst Partial Pancreatectomy Whipple Resection Total Pancreatectomy Pancreaticojejunostomy (Peustow) Internal Drainage Pseudocyst of 11

6 ADVANCED LAPAROSCOPY/MINIMALLY INVASIVE SURGERY (CONTINUED) Abdominal Wall (laparoscopically or endoscopically) Inguinal Hernia, Laparoscopic Adult Umbilical Adult Femoral Ventral Incisional Initial Endocrine Thyroid Lobectomy Total Thyroidectomy Parathyroidectomy Adrenalectomy Genitourinary (laparoscopically or endoscopically) Adrenalectomy Cystotomy Cystostomy Cystectomy Partial Nephrectomy Liver Donor Nephrectomy BARIATRIC SURGERY Open / Laparoscopic/Endoscopic Gastric Band Roux-en-Y Sleeve Gastrectomy ROSE Procedure 6 of 11

7 SURGICAL ONCOLOGY Breast Fine Needle Aspir w/image Adjacent Tissue Transfer /Rearrangement 14301, Excision of Chest Wall Tumor Including Ribs Excision of Chest Wall Tumor Involving Ribs Preoperative Placement of Needle Localization Wire, Breast Preoperative Placement Each Additional Lesion Image Placement Metallic Clip, Percutaneoius, during Breast Biopsy Placement of Radiotherapy , Ultra Guide/Needle Biopsy Sup & Interp Echography Breast Unilateral/Bilateral Intraoperative Ultrasound Nipple/Areola Reconstruction Sentinal Lymph Node Biopsy Procedure Hepato/Pancreatico/Biliary Hepatic Lobectomy Total Pancreatectomy Hepatico Jejunostomy Choledocho Jejunostomy Radio Frequency Ablation of Hepatic Tumors Esophagus Excision Esophageal Lesion, Primary Repair Esophagectomy, Thoracotomy Esophagectomy, Transhiatal Esophagogastrectomy Thoracic????? Soft Tissue/Melanoma Excision of Extremity Soft Tissue Sarcoma Sentinal Lymph Node Biopsy 7 of 11

8 TRANSPLANT Liver Liver Transplant (cadaver or living) 47135/47136 Jump Graft Kidney Jump Graft Liver Live Donor Hepatectomies 47140//47141/47142 Major Liver Resections 47120/47122/47125/47130 Lap Liver Resections (unlisted) Lap & Open Radiofrequency Liver Ablations Portal Decompressive Procedure Split Liver Transplantation and Procurements. Pancreas Pancreas Transplant Pancreatic Lesion Excision Percutaneous Pancreas Biopsy 47370/47371 (laparoscopic (open) Kidney Renal Transplant (cadaver or living) Lap Nephrectomy Open Nephrectomy Percutaneous Kidney Biopsy Percutaneous Liver Biopsy Adrenalectomy 60540/60545 Dialysis Access Percutaneous A-V Fistula Surgery Peritoneal 8 of 11

9 TRAUMA/ACUTE CARE/CRITICAL CARE SURGERY Critical Care Airway Maintenance Intubation including fiberoptic bronchoscopy and laryngoscopy Temporary Cardiac Pacemaker Insertion and Application Cardioversion Echocardiography and Electrocardiography Interpretation 93314, Esophagoscopy and Gastroscopy with PEG Insertion Insertion of Central Venous, Arterial and Pulmonary Artery Balloon Flotation Catheters Insertion of Hemodialysis and Peritoneal Dialysis Catheters Intracranial Pressure Monitoring Lumbar puncture 62270, Management of Anaphylaxis and Acute Allergic Reactions E&M Management of life-threatening disorders in intensive care units including but not limited to shock, coma, heart failure, trauma, respiratory arrest, drug overdoses, massive bleeding, diabetic acidosis and kidney failure E&M Needle and Tube Thoracostomy Paracentesis Percutaneous Tracheostomy/Cricothyrotomy Tube Placement Pericardiocentesis Peritoneal lavage Thoracentesis Tracheostomy Image Guided Procedures Ventilator management, including experience with various modes and continuous positive airway pressure therapies (BiPAP and CPAP) 94002, 94003, Administration of Sedation and Analgesia Admit, evaluate, diagnose, and provide treatment or consultative services to critically ill adult patients with postsurgical or post-traumatic multiple organ dysfunction and in need of critical care for life threatening disorders. Assess, stabilize, and determine disposition of patients with emergent conditions consistent with medical staff policy regarding emergency and consultative call services. E&M Trauma Evaluation and admission of all adult Level 1, 2, and 3 injured patients with criteria specified by the Trauma Program Director as reflected in hospital policy. Resuscitation and stabilization of adult injured patients using evaluation modalities including, but not limited to, FAST ultrasound E&M E&M Assessment and treatment of injured patients requiring operative intervention. Credentialed providers may provide emergency care of all neck, thoracic, abdominal and vascular injuries proximal to the knee or elbow with appropriate consultation of 11

10 THORACIC SURGERY Thoracic/Esophagus/Diaphragm (laparoscopically or endoscopically) Mediastinoscopy Mediastinotomy Excision Mediastinal Tumor Thymectomy Transthoracic Drainage Empyema Pulmonary Lobectomy Pulmonary Wedge Resection, Open Pulmonary Segmental Resection, Open Repair Tracheo-Esophageal Fistula Creation Pericardial Window Vagotomy, All Cricopharyngeal Myotomy Esophageal Perforation Repair / Drainage Thoracoscopy Thoracoscopy Pleurodesis, Thoracoscopic Pulmonary Decortication, Thoracoscopic Pulmonary Wedge Resection, Thoracoscopic Pulmonary Segmental Resection, Thoracoscopic Exploratory Thoractomy Pneumonectomy of 11

11 VASCULAR Angiography, Carotid Angiography, Aorta Angiography, Extremity Angiography, Visceral Correction Thoracic Outlet Obstruction Excision Aneurysm, Upper Extremity Excision Aneurysm, Lower Extremity Repair Aneurysm Abdominal Aorta Excision False Aneurysm Carotid Endarterectomy Endarterectomy, Aortoiliofemoral Carotid Subclavian Bypass Axillo Femoral Bypass Aorto Iliac or Femoral Bypass Femoro Femoral Bypass Femoro Popliteal Bypass Femoro Tibial Bypass Renal Artery Revascularization Mesenteric Revascularization Procedures Insert IVC Filter Portosystemic Shunt Creation AV Fistula Placement AV Graft Removal Infected / Nonfunctional Graft Iliac Angioplasty with or without Stent Fem Pop Angioplasty with or without Stent Tibial Angioplasty with or without Stent Endovascular AAA Repair (1 Limb) Endovascular AAA Repair (2 Limb) Pulse Thrombolysis LEVEL II ADVANCED PRIVILEGES ROBOTIC(CONTACT PERIOPERATIVE SERVICES FOR ROBOTIC PRIVILEGING) LEVEL II ADVANCED PRIVILEGES LASER 11 of 11